NRSG376 - Integrating Practice 6

Year

Credit points

Campus offering

Prerequisites

NRSG373 Integrating Practice 5

Unit rationale, description and aim

Safe practice and safety of the public is paramount within nursing. This final third year integrated practice unit scaffolds learning from previous years, and first semester in third year, to prepare nursing students at a mastery level to be safe nurses. Unit NRSG373 is a prerequisite for NRSG376 and in NRSG376 students consolidate skills and knowledge and move towards mastery in examining, critiquing and applying theory to practice. Reflection in and on practice is scaffolded from second year units and students are encouraged to become autonomous and accountable in their practice. In preparation for practice as a registered nurse, application of critical reasoning to promote safe practice is paramount. The clinical reasoning skills of assessment, planning, implementation, evaluation and reflection at a mastery level are consolidated in NRSG376. This unit also introduces students to foundational skills in counselling, that can be applied to therapeutic interactions with individuals.

This unit enables students to draw on previous learning in all subjects and integrate theoretical and practical knowledge gained in the course to date. NRSG376 is a capstone unit which uses simulation classes so that students establish mastery in nursing practice skills with advanced theoretical knowledge during scenario based learning in the simulation practical class.

The aim of this final Integrated Practice unit is to consolidate skills and knowledge through to application in practice at a mastery level. The integrated practice units in third year aim for students to be work ready, critically reflective learners who are safe in practice. 

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

NMBA Registered Nurse Standards for Practice

The Nursing and Midwifery Board of Australia’s Registered Nurse Standards for Practice developed in this unit are:

Content

Topics will include:

• Person-centred practice
• Application of person-centred practice in the provision of care:
• Providing the person with opportunities for choice and decision making in relationship to their care and treatment and respect for those choices and decisions
• Professional & therapeutic communication
• Negotiation and challenges and conflict resolution
• De-escalation techniques - management of clinical aggression/establishment of a safe environment.
• Participation in difficult conversations including death and dying
• Oppressed group behaviour
• Collaborative practice and communication within interprofessional teams
• Nursing assessment
• The deteriorating patient
• Emergency situations (escalation & de-escalation)
• Initiating appropriate assessments during clinical deterioration including haemodynamic instability
• Provision, coordination & evaluation of care
• Managing cognitive impairment and challenging behaviors
• Goal setting and recovery and wellness planning
• Prioritising care and time management
• Initiation of nursing care
• Nursing care of the palliative patient including specific hygiene cares
• Quality use of medicines
• Managing medication Oral, S/C, IMI, IV, PCAs, PICCs (CVAD), Syringe Drivers
• Use of drugs in palliation 
• Health promotion & education
• Teaching a colleague
• Health promotion and community education
• Diversity & cultural competence
• Identifying cultural and religious groups and extending knowledge of cultural/religious beliefs and practices
• Professional capabilities
• Prioritising care in a changing environment 
• Time management in a changing environment
• Delegation
• Resilience
• Reflective practice
• Developing a professional identity
• Professional development
• Clinical leadership
• Managing change
• Clinical reasoning
• Applying clinical reasoning and judgement in advanced practice
• Reflecting on practice - clinical decision making and judgement 

Learning and teaching strategy and rationale

Modes of delivery in NRSG376 include lectures, simulation, practical classes, online activities, professional experience placement and self-directed study. Consistent with adult learning principles, the teaching and learning approaches used within these modes of delivery will provide students with the foundational knowledge and skills that are relevant to professional nursing practice. The teaching and learning strategy also supports students in meeting the aim, learning outcomes and graduate attributes of the unit, and the broader course learning outcomes. The learning and teaching strategy also reflects respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.

Students undertaking a tertiary qualification need skills to assist them to manage their ongoing individual learning. Therefore, feedback and critical self-reflection are required to identify what is being done well, what requires additional work, to identify progress toward the required learning outcomes. The professional experience placement assists students to link theory with clinical practice. Located in the third year of the program, NRSG376 includes face-to-face teaching and learning activities, and a self-directed learning component that aims to affirm life-long learning skills. Lectures are used to convey content and central principles, and simulation classes aim to deliver interactive learning sessions which will assist students to apply theory to clinical practice and build critical reflective skills. Simulation classes also provide an opportunity to continue to build community learning skills. Supervised professional experience placement provides a safe environment to provide the assisted, person-centred care that is essential for successful graduate practice. 

Assessment strategy and rationale

The assessments are constructively aligned to the six learning outcomes of unit NRSG376 and the learning outcomes of the program and graduate attributes.

NRSG376 has 240 hours of professional experience placement that students are required to complete. Completing 100% of professional experience shifts is a requirement to pass this unit.

Students are required to submit a medical certificate or statutory declaration for any professional experience placement hours missed. Instructions on submitting this documentation is available in the Student Placement Experience Manual. All hours missed due to non-attendance at professional experience placement must be completed prior to successfully completing the unit. An interim grade of “IP” will be made if 100% attendance at professional experience placement is not achieved. Successful completion of your nursing degree requires a minimum amount of 800 hours of professional experience placement, and this must be completed incrementally throughout your program of study.

A range of assessment items consistent with University assessment requirements and policy will be used to ensure that students achieve the unit learning outcomes and attain the graduate attributes. Competence during professional experience placement will be assessed using the Australian Nursing Standards Assessment Tool (ANSAT).

In real-world practice, it is a requirement that the registered nurse has the ability to complete accurate medication administration. This requirement exists because errors in the calculations of drug dosages, or errors in drug administration can have severe, adverse health consequences for patients. NRSG376 requires a mandatory pass grade for the ANSAT assessment component of professional experience placement because, in nursing, professional competence is a necessary job requirement. Achieving a pass grade for the Clinical Skills Portfolio is also mandatory. The Clinical Skills Portfolio will support student employment applications as well as the continuing professional development required for registration as a nurse. To achieve a pass grade for NRSG376, all four hurdle tasks need to be completed successfully.

These assessments are required to build student knowledge and skills which, by the conclusion of this program, will enable the student to graduate as a safe and effective nurse. For these assessments:

• The Clinical Portfolio assessment is an “Ungraded Hurdle” (PASS/FAIL), noting a Pass for this task requires 100% for the exam) with three attempts permitted. This assessment is conducted as an invigilated exam. If the student is unsuccessful on the first attempt, remediation is given prior to the third and final examination attempt. Successful achievement of 100% is required for eligibility to attend professional experience placement. The National Assessment Review Committee may, in exceptional circumstances, grant one further attempt ‘only’.
• Australian Nursing Standard Assessment Tool (ANSAT) is an “Ungraded Hurdle” (PASS/FAIL) with only one attempt. The rationale for only one attempt is that students are not able to be granted multiple clinical placements.
• Drug Calculation is an “Ungraded Hurdle”(PASS/FAIL) with multiple attempts prior to the published due date, when students must submit a completed Clinical Portfolio in order to receive a pass. The National Assessment Review Committee may, in exceptional circumstances, grant one further attempt ‘only’. 
• Attendance at 100% of professional experience placement hours is an “Ungraded Hurdle” (PASS/FAIL). Completion of professional experience placement hours are an important step towards completion of the minimum amount of 800 hours of professional experience placement that is required within your degree. Make-up may be granted if a medical certificate(s) or Statutory Declaration (maximum of one day absence) is submitted and approved for any professional experience placement hours missed. The requirements and procedures for applying for make-up are available in the Student Placement Experience Manual. Strict timelines and procedures apply.

Attendance at laboratory simulation classes in IP units

You are required to attend all laboratory simulation classes in NRSG376. This 100% minimum attendance requirement for laboratory simulation classes is mandated because attendance at these classes is integral to achievement of the learning outcomes in NRSG376. Attendance and active participation at laboratory simulation classes are also an essential component of preparation for your professional experience placement in NRSG376.

If you have an illness, and/or personal circumstance beyond your control that leads to your non-attendance at laboratory simulation classes you will be expected to provide a medical certificate or Statutory Declaration to support your absence for each class missed. The procedure for uploading this documentation will be provided on Canvas. Make-up will only be provided for students with appropriate supporting documentation, and in exceptional circumstances, as determined by the Lecturer-in-Charge. The procedure for lodging the Practical Class Absenteeism form is provided on Canvas.

As part of Standard 1: Safety of the public in The Registered Nurse Accreditation Standards (ANMAC, 2019), standard 1.7 stipulates that “only students who have demonstrated the requisite knowledge and skills required for safe practice are eligible for PEP [professional experience placement]”. It is an expectation therefore that students attend their laboratory simulation classes to demonstrate they have obtained the required knowledge and skills to attend their professional experience placements.

If you do not meet the minimum attendance requirement for laboratory simulation classes in NRSG376 then you will be ineligible to undertake the pre-placement assessment and will therefore be unable to attend professional experience placement. This will lead to a NU grade for NRSG376 as you will be unable to successfully complete the required assessment tasks and demonstrate achievement of the Unit learning outcomes.

If you think you will not be able to meet the mandatory attendance requirements in NRSG376 please contact your Lecturer-in-Charge as soon as possible to discuss.

Pre-placement Requirements

NRSG376 requires students to meet pre-placement requirements by the compliance due date specified within InPlace. The Faculty of Health Sciences require students to meet pre-placement compliance to ensure that students hold the essential checks, immunisations, and training for placement eligibility. All students must meet mandatory State or Territory legal and industry policy requirements prior to being allocated a placement. Students must fulfill a standard set of pre-placement requirements as set out by the Faculty of Health Sciences in the ACU Work Integrated Learning site to be eligible to go on professional experience placements. Failure to meet these pre-placement requirements by the specified compliance due date means students are ineligible for professional experience placement allocation and will receive an NU (Fail) grade for NRSG376.

Fitness to Practice

Prior to attending professional experience placement, all students are required to meet the inherent and mandatory documentation requirements including ‘fitness to practice.’ It is imperative that students are fit for professional practice, without physical or mental health impairments which could affect their own safety or the safety of the public, for whom they will be providing health care. This is in alignment with The Health Practitioner Regulation National Law Act (2009). Students are required to complete an online Fitness for Practice Declaration via InPlace within the first three weeks of any semester where they are enrolled into an Integrating Practice unit with professional experience placement. The Fitness for Practice Declaration is part of the student’s preplacement requirements, and it is an expectation that this declaration will be completed prior to every professional experience placement the student attends. It is essential for students to disclose any condition/s they are aware of that would make them unfit for practice. Failure to complete the Fitness to Practice Declaration means students are ineligible for professional experience placement allocation and will receive an NU (Fail) grade for NRSG376.

Overview of assessments

Representative texts and references

Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (Eds.). (2021). Potter & Perry’s fundamentals of nursing (6e ; Australia and New Zealand edition). Elsevier Australia a division of Reed International Books Australia Pty Ltd.

Jarvis, C., & Strandberg, K. (2016). Jarvis’s physical examination & health assessment (H. (Helen V. Forbes & E. Watt, Eds.; 2nd ed.; Australian and New Zealand ed.). Elsevier Australia.

Holland, K., & Jenkins, J. (2019). Applying the Roper-Logan-Tierney model in practice (3rd ed.). Elsevier.

Levett-Jones, T. (Ed.). (2022). Clinical reasoning : learning to think like a nurse (3rd ed.). Pearson Australia.

McCabe, C., & Timmons, F. (2013) Communication skills for nursing practice (2nd ed.). Palgrave McMillan.

Rebeiro, G., Jack, L., Scully, N., & Wilson, D. (2016). Fundamentals of nursing clinical skills workbook (3rd ed.). Elsevier Australia.